Over 80% of people will experience back pain at some point in their lives. And many of those people will have recurring episodes of back pain. The pain subsides, they think they’re out of the woods and then 6 months later it comes back. And then it goes away….and then only 3 months later it comes back and now it’s not going away so fast. And so on and so on.
And the person gets increasingly frustrated each time the pain comes back and now they worry about it happening just about every day. They can’t enjoy the active lifestyle they once had because either they physically can’t do those things anymore or even if they can, they are afraid it will cause the pain to come back.
So why does the pain go away for a while and then come back? Here are the 5 reasons I have come across most often in my 10+ years of treating athletes and active people:
1. You Haven’t Actually Done Anything To Fix the Problem
This is by far the most common reason people’s back pain cycles on and off. When I meet people and tell them that what I do for a living (physical therapist), so many people go on to tell me about their back pain and how it’s annoying, frustrating, etc. And when I ask them what they have done for it, the typical response is nothing…or just take some pain meds!
How can you expect your pain problem to get better if all you do for it is say a prayer at night and hope it will go away on its own!?
And the more people have talked to me about their back problem (really any problem), I realized that a lot of people choose not to do anything because they simply don’t know which of the many options out there is the best choice for them. And they’re afraid of making the wrong decision or confused of even where to start. So instead, they live in this paralyzed (not literally) state of indecision and continued pain that limits their active lifestyle.
This is why I set up my clinic to offer a few different free options to help people BEFORE they commit to us. It’s a way for people to learn what they can do for their problem and see what option works best for them.
2. The Treatment(s) You Got Didn’t Address the Underlying Issue
For those people who got some form of treatment and the pain still comes back, there’s a good chance that the treatment they got (i.e. injections, medications, bad PT, etc.) only took care of the symptoms/pain and didn’t address the underlying reason for their problem.
It’s like having someone help you bail water out of your sinking ship versus having someone help you plug the hole. It’s the difference between constantly having to worry about it happening again and being able to enjoy the things you love to do without worry.
3.You Didn’t Follow Through With Your Treatment Plan and/or “Homework”
There are times when someone is getting a good treatment that is working on the underlying cause, but when they start to feel much better, they decide to stop the treatment plan early…and a few months later they’re back in with a “flare-up.” And this “flare-up” may have been avoided had they saw their treatment plan all the way through and not quit just when the pain went away. Remember, addressing the underlying issue is key!
Other times, people don’t do their physical therapy “homework” – the tips and advice given to them to do on their own time. If you see us 2 x week for an hour each time, that’s only 2% of your entire week. What you do in the other 98% will have a HUGE effect on your outcome.
4. You Progressed Your Activity Level Too Quickly
Another classic reason for someone’s back pain to come back. They start feeling a lot better so they decide that a 10 mile bike ride is ok to do…even though they haven’t ridden in a couple months. Or they’re feeling good because they’re finally back in the gym…and they decide the “boot camp” class that was going on that day was a good idea. Or a friend asks them to do a charity 5k with them…it’s for charity so it’s ok, right!?
You’re probably chuckling right now…not because the examples are that funny, but because you know you’ve been guilty of it.
I understand that when the pain starts to go away, you get excited to do things again, but you have to make sure it all makes sense with regards to your treatment plan – both short and long-term.
5. The Rest of Your Life Isn’t Healthy
You don’t sleep well. You’re stressed. You work too much. You don’t eat well. You’re overweight. You’re out of shape. You get the idea.
All those things play a role in your recovery and can affect your expected outcome – both amount of relief expected and the time it will take to get that relief. If you can’t get those things in control, the odds of a successful outcome go down…it’s that simple (and I know that simple doesn’t mean easy).
Dr. Dennis Treubig, PT, DPT, SCS, CSCS
Hello, my name is Dennis Treubig. Since graduating from the University of Delaware (#1 PT school in the country), I have worked relentlessly to hone my skills and knowledge so that I can be the leading sports injury expert in the area. Over the years, I have become one of the less than 1% of therapists who have attained the title of Board Certified Specialist in Sports Physical Therapy.
I founded Modern Sports Physical Therapy so that there would be a place where athletes and active people could go to quickly recover from their injury and get out of pain so they could get back to doing the things they love to do.